Provider Demographics
NPI:1356331912
Name:DEMOTT, THOMAS STEVEN (DC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:STEVEN
Last Name:DEMOTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 SAW MILL RIVER RD
Mailing Address - Street 2:STE 2NB
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-2146
Mailing Address - Country:US
Mailing Address - Phone:914-478-1300
Mailing Address - Fax:
Practice Address - Street 1:631 SAW MILL RIVER RD
Practice Address - Street 2:STE 2NB
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-2146
Practice Address - Country:US
Practice Address - Phone:914-478-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003802 1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX2356XCRS1Medicare PIN